Total soft-tissue reconstruction of the middle and lower face with multiple simultaneous free flaps in a pediatric patient

A 2-year-old boy sustained a massive facial soft-tissue wound secondary to a dog attack. Essentially all the soft tissues of the face were absent, including innervation and intraoral lining. We describe the reconstruction of this defect with five simultaneous free tissue transfers. To our knowledge, this is the first report of five simultaneous free flaps in any patient.     

An autosomal genomic scan for loci linked to type II diabetes mellitus and body-mass index in Pima Indians.

Genetic factors influence the development of type II diabetes mellitus, but genetic loci for the most common forms of diabetes have not been identified. A genomic scan was conducted to identify loci linked to diabetes and body-mass index (BMI) in Pima Indians, a Native American population with a high prevalence of type II diabetes. Among 264 nuclear families containing 966 siblings, 516 autosomal markers with a median distance between adjacent markers of 6.4 cM were genotyped. Variance-components methods were used to test for linkage with an age-adjusted diabetes score and with BMI. In multipoint analyses, the strongest evidence for linkage with age-adjusted diabetes (LOD = 1.7) was on chromosome 11q, in the region that was also linked most strongly with BMI (LOD = 3.6). Bivariate linkage analyses strongly rejected both the null hypothesis of no linkage with either trait and the null hypothesis of no contribution of the locus to the covariation among the two traits. Sib-pair analyses suggest additional potential diabetes-susceptibility loci on chromosomes 1q and 7q.     

A PHYLOGENETIC PERSPECTIVE ON THE EVOLUTION OF SEXUAL DICHROMATISM IN TANAGERS (THRAUPIDAE): THE ROLE OF FEMALE VERSUS MALE PLUMAGE

The evolution of sexual dichromatism in tanagers (family Thraupidae) was studied from a phylogenetic perspective using a molecular-based phylogeny. Mapping patterns of sexual dimorphism in plumage onto the phylogeny reveals that changes in female plumage occur more frequently than changes in male plumage. Possible explanations for this pattern include sexual selection acting on female plumage and natural selection for background matching. The results of this study and other recent phylogenetic and comparative studies suggest that factors affecting female plumage are important in shaping patterns of sexual dimorphism.     

A retrospective analysis of factors contributing to calf mortality and dystocia in beef cattle

Records of 2191 calvings from the Clemson University Beef Physiology Unit between 1981 and 1993 were analyzed to determine factors affecting malpresentation, mortality and dystocia. Only 20 (0.91%) parturitions involved malpresentation: posterior presentation (n = 14), leg deviations (n = 3), head deviations (n = 2) and breech birth (n = 1). Dystocia affected calf mortality within 24 h of birth (P < 0.05), with mortality increasing as the severity of dystocia increased. There was an overall 4.5% death loss within 24 h of birth, with 4 and 7% mortality rates for calves from multiparous and primiparous dams, respectively (P < 0.05). Mortality was higher for bull vs heifer calves (P < 0.05). Ninety-four percent of calvings were unassisted, while 6% were assisted births. Dystocia was greater (P < 0.01) in primiparous (17%) than in multiparous dams (4%). In births involving dystocia, 28.1% required mild traction, 69.3% required heavy traction and 2.6% required Cesarean section. Birth weights associated with normal births and mild traction (36 and 36 kg) were lighter than those associated with heavy traction and Cesarean section (40 and 42 kg, respectively; P < 0.05). In conclusion, malpresentations were too few to be of significance, and dystocia influenced mortality within 24 h of birth. Calf birth weight and parity of dam explained most of the observed variations in dystocia.     

Comparative effects of early weaning or once-daily suckling on occurrence of postpartum estrus in primiparous beef cows

We concurrently evaluated early weaning and once-daily suckling as options for shortening postpartum interval to estrus in primiparous cows calving in good body condition. Over 2 consecutive years, a total of 77 primiparous cows were assigned to 1 of 3 treatments: control (ad libitum suckling); once-daily suckling (for 30 d prior to start of breeding); or early weaning (calves weaned 30 d prior to start of breeding). All cows had a body condition score (BCS) of > or = 5 at parturition and were maintained in good condition throughout the breeding season. Cows were observed for estrus twice daily and blood samples for subsequent measurement of progesterone were collected at 48-h intervals. For data analysis, cows were divided into early- (> or = 85 d post partum) and late-calving (< 85 d post partum) groups at the onset of the breeding season. All calves were weighed at birth, at the onset of treatment, at weekly intervals until the start of the breeding season, and within 45 d of 205 d of age. Early weaning or once-daily suckling shortened the postpartum interval to first estrus of late-calving primiparous cows by 17 (P < 0.01) and 12 d (P < 0.08), respectively, compared with control group cows. However, among early-calving cows, neither early weaning nor once-daily suckling influenced the postpartum interval. Postpartum intervals of once-daily suckled cows and early-weaned cows were similar (P > 0.10).     

Retention of NO_3^ - in an upland streamenvironment: A mass balance approach

Models of the effects of atmosphericN deposition in forested watersheds have notadequately accounted for the effects of aquatic andnear-stream processes on the concentrations and loadsof NO in surface waters. This studycompared the relative effects of aquatic andnear-stream processes with those from the terrestrialecosystem on the retention and transport ofNO in two contrasting stream reaches ofthe Neversink River, a forested watershed in theCatskill Mountains of New York that receives among thehighest load of atmospheric N deposition in thenortheastern United States. Stream water samples werecollected every two hours and ground-water andtributary samples were collected daily at base flowconditions during four 48-hour periods from April toOctober 1992, and NO mass balances werecalculated for each site. Results indicated diurnalvariations in stream NO concentrations inboth reaches during all four sampling periods; this isconsistent with uptake of NO byphotoautotrophs during daylight hours. Mass-balanceresults revealed significant stream reach losses ofNO at both sites during all samplingperiods. The diurnal variations in NO concentrations and the retention of NO relative to terrestrial contributions to the streamreaches were greater downstream than upstream becausephysical factors such as the head gradients ofinflowing ground water and the organic matter contentof sediment are more favorable to uptake anddenitrification downstream. The mass retention ofNO increased as the mean 48-hr streamdischarge increased at each site, indicating that theresponsible processes are dependent onNO supply. Low stream temperatures duringthe April sampling period, however, probably reducedthe rate of retention processes, resulting in smallerlosses of NO than predicted from streamdischarge alone. Water samples collected from thestream, the hyporheic zone, and the alluvial groundwater at sites in both reaches indicated that the neteffect of hyporheic processes on downstreamNO transport ranged from conservativemixing to complete removal by denitrification. Therelative effects of biological uptake anddenitrification as retention mechanisms could not bequantified, but the results indicate that bothprocesses are significant. These results generallyconfirm that aquatic and near-stream processes causesignificant losses of NO in the NeversinkRiver, and that the losses by these processes atdownstream locations can exceed the NO contributions to the stream from the terrestrialenvironment during summer and fall base-flowconditions. Failure to consider these aquatic andnear-stream processes in models of watershed responseto atmospheric N deposition could result inunderestimates of the amount of NO leaching from forested ecosystems and to an inabilityto unequivocally relate geographic differences inNO concentrations of stream waters tocorresponding differences in terrestrial processes.     

Exercise-induced suppression of acylated ghrelin in humans.

Ghrelin is an orexigenic hormone secreted from endocrine cells in the stomach and other tissues. Acylation of ghrelin is essential for appetite regulation. Vigorous exercise induces appetite suppression, but this does not appear to be related to suppressed concentrations of total ghrelin. This study examined the effect of exercise and feeding on plasma acylated ghrelin and appetite. Nine male subjects aged 19-25 yr participated in two, 9-h trials (exercise and control) in a random crossover design. Trials began at 0800 in the morning after an overnight fast. In the exercise trial, subjects ran for 60 min at 72% of maximum oxygen uptake between 0800 and 0900. After this, they rested for 8 h and consumed a test meal at 1100. In the control trial, subjects rested for 9 h and consumed a test meal at 1100. Area under the curve values for plasma acylated ghrelin concentration (assessed from venous blood samples) were lower over the first 3 h and the full 9 h of the exercise trial compared with the control trial: 317+/-135 vs. 510+/-186 pg.ml(-1).3 h and 917+/-342 vs. 1,401+/-521 pg.ml(-1).9 h (means+/-SE) respectively (P<0.05). Area under the curve values for hunger (assessed using a visual scale) were lower over the first 3 h of the exercise trial compared with the control trial (P=0.013). These findings demonstrate that plasma acylated ghrelin concentration and hunger are suppressed during running.     

C-peptide as a Therapy for Kidney Disease: A Systematic Review and Meta-Analysis

C-peptide has intrinsic biological activity and may be renoprotective. We conducted a systematic review to determine whether C-peptide had a beneficial effect on renal outcomes. MEDLINE, EMBASE, and the Cochrane Central Databases were searched for human and animal studies in which C-peptide was administered and renal endpoints were subsequently measured. We identified 4 human trials involving 74 patients as well as 18 animal studies involving 35 separate experiments with a total of 641 animals. In humans, the renal effects of exogenously delivered C-peptide were only studied in type 1 diabetics with either normal renal function or incipient nephropathy. Pooled analysis showed no difference in GFR (mean difference, -1.36 mL/min/1.73 m2, p = 0.72) in patients receiving C-peptide compared to a control group, but two studies reported a reduction in glomerular hyperfiltration (p<0.05). Reduction in albuminuria was also reported in the C-peptide group (p<0.05). In diabetic rodent models, C-peptide led to a reduction in GFR (mean difference, -0.62 mL/min, p<0.00001) reflecting a partial reduction in glomerular hyperfiltration. C-peptide also reduced proteinuria (mean difference, -186.25 mg/day, p = 0.05), glomerular volume (p<0.00001), and mesangial matrix area (p<0.00001) in diabetic animals without affecting blood pressure or plasma glucose. Most studies were relatively short-term in duration, ranging from 1 hour to 3 months. Human studies of sufficient sample size and duration are needed to determine if the beneficial effects of C-peptide seen in animal models translate into improved long-term clinical outcomes for patients with chronic kidney disease. (PROSPERO CRD42014007472)     

Population Genetic Structure Within and among Seasonal Site Types in the Little Brown Bat (Myotis lucifugus) and the Northern Long-Eared Bat (M. septentrionalis)

During late summer and early autumn, temperate bats migrate from their summering sites to swarming sites, where mating likely occurs. However, the extent to which individuals of a single summering site migrate to the same swarming site, and vice versa, is not known. We examined the migratory connectivity between summering and swarming sites in two temperate, North American, bat species, the little brown bat (Myotis lucifugus) and the northern long-eared bat (Myotis septentrionalis). Using mitochondrial and microsatellite DNA markers, we examined population structuring within and among summering and swarming sites. Both species exhibited moderate degrees of mitochondrial DNA differentiation (little brown bat: F_ST(SWARMING)= 0.093, F_ST(SWARMING)= 0.052; northern long-eared bat: F_ST(SWARMING)= 0.117, F_ST(SWARMING)= 0.043) and little microsatellite DNA differentiation among summering and among swarming sites. Haplotype diversity was significantly higher at swarming sites than summering sites, supporting the idea that swarming sites are comprised of individuals from various summering sites. Further, pairwise analyses suggest that swarming sites are not necessarily comprised of only individuals from the most proximal summering colonies.